MEDICARE: CANCER CENTER OF THE CARIBBEAN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RH0003X	Hematology & Oncology Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	340921	OTHER	PR	CERTIFICATION

General Provider Information

NPI Number	:	1912308610
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CANCER CENTER OF THE CARIBBEAN

Provider Business Mailing Address
First Line	:	1427 AVE. MANUEL FERNANDEZ JUNCOS
Second Line	:	SUITE 101
City	:	SAN JUAN
State	:	PR
Zip	:	00910-0000
Country	:	US
Telephone Number	:	787-722-9030
Fax Number	:	787-722-9049

Provider Business Practice Location Address
First Line	:	1427 AVE. MANUEL FERNANDEZ JUNCOS
Second Line	:	SUITE 101
City	:	SAN JUAN
State	:	PR
Zip	:	00910-0000
Country	:	US
Telephone Number	:	787-722-9030
Fax Number	:	787-722-9049

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. MARIA E PEREZ
Credential	:	M.D.
Telephone Number	:	787-722-9030

Provider Enumeration Date	:	09/12/2014
Last Update Date	:	09/12/2014

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Directions to “CANCER CENTER OF THE CARIBBEAN ” Practice Location

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